Associação da violência entre parceiros íntimos com o ganho de peso inadequado na gestação

Abstract

Pregnant women who gain weight off recommendations have more complications in mother and child health. Studies report maternal age, pre-pregnancy weight, parity, hypertension, diabetes, smoking and marital status as associated with inadequate weight gain factors. Others point out that maternal mental health problems can harm the appropriate gestational weight gain. There are few studies on the association between intimate partner violence (IPV) with inappropriate gestational weight gain (GWG). In this perspective, this study aimed to investigate the association between IPV and GWG. It comes from a prospective cohort study on the role played by family violence, by maternal child care and the social support in the determination of child growth. This sectional-type research included 554 women who attended the four Basic Health Units in the municipality of Rio de Janeiro between 2005 and 2009. GWG was calculated from the difference between the final weight of pregnancy and the last query regarding prenatal, and pre-pregnancy weight. To obtain the exposure, the Portuguese version of the CTS - 1 instrument (Conflict Tactics Scales - Form R) (HASSELMANN; REICHENHEIM, 2003) was used. Data analysis was based on multinomial logistic regression models, estimating odds ratios and corresponding 95% confidence for associations between variables. It was observed that 32.7% of the global intimate partners use physical violence to resolve their differences. When divided between lower and higher, physical violence showed 31.6% and 16.2%, respectively. In relation to gestational weight gain, 65.2% of women gained weight out of the recommendations of the IOM (2009); 31.8% had insufficient weight gain and 33.4%, excessive gain. In simple multivariate analyses, we found that the presence of physical intimate partner violence was significantly associated with insufficient gestational weight gain; this situation occurred both for overall physical violence [OR = 1.57; (95% CI) = 1, 02 2.43] and for the smallest physical violence [OR = 1.58; (95% CI) = 1.02 2.44]. However, after adjusting for confounding variables (number of prenatal visits, maternal education, parity, and environmental conditions), this relationship loses significance. Regarding excessive gestational weight gain, there was no association with the types of IPV. The results of this investigation indicate the need for attention and practical approach in the care of pregnant women during prenatal visits because it is an opportunity to identify nutrient disorders and tracking of domestic violence